iCliniq Logo
HomeHealth articlesMedical oncologyradiation therapy
Cancer

Brachytherapy for Prostate Cancer Treatment

Verified data
0

7 min read

Share

Outline

For many men, brachytherapy treats prostate cancer effectively by targeting the cancer directly while protecting nearby healthy tissue.

Written byDr. Vedangi Arvind Mohite

Medically reviewed byDr. Rajesh Gulati

Published At November 24, 2022
Reviewed AtMay 29, 2026

What Is Brachytherapy for Prostate Cancer?

The brachytherapy method of treating prostate cancer that has not metastasized from the prostate gland has been shown to be quite successful, with one study showing that the 17-year survival rate is about 97%. In this form of therapy, the surgeon implants small radioactive rods or seeds inside the prostate gland.

Brachytherapy is less invasive than major surgery. The procedure usually takes about 60 to 90 minutes, and many patients go home the same day. It is also called internal radiation therapy. Unlike external beam radiation therapy (EBRT), the radiation is delivered from inside the body.

What Is the Purpose of Brachytherapy?

The main goal of brachytherapy is to treat prostate cancer while protecting healthy tissue around the prostate.

Doctors may recommend brachytherapy to:

  • Control or destroy the cancer.

  • Lower the chance of the cancer spreading or returning.

  • Avoid major surgery.

  • And help patients recover faster.

For many men, brachytherapy offers effective cancer treatment with less disruption to daily life.

What Are the Types of Prostate Brachytherapy?

Prostate brachytherapy has two basic forms. The method recommended by your physician will depend upon: the aggressiveness of your cancer, the size of your prostate gland, and your general condition.

  1. Low-Dose Rate (LDR) Brachytherapy:

Low-dose-rate (LDR) brachytherapy is the more widely performed procedure. In LDR brachytherapy, 50 to 100 radioactive pellets or "seeds" are implanted into your prostate. These small seeds are approximately the same size as a grain of rice and give off their radiation gradually. Each seed is about the size of a grain of rice.

The seeds stay inside the prostate permanently, but over time, they stop releasing radiation and become inactive. They usually do not cause long-term problems. The seeds slowly release small amounts of radiation over several weeks or months. This helps destroy cancer cells while reducing damage to nearby healthy tissue.

Common radioactive seeds used include:

  • Iodine-125.

  • Palladium-103.

  • Cesium-131.

Iodine-125 is the most widely used because it has a long safety record in prostate cancer treatment.

Radiation Safety After LDR Treatment: For a short time after treatment, the seeds still release small amounts of radiation. Because of this, doctors may advise you to:

  • Try to avoid staying close to pregnant women and young children.

  • Avoid letting children sit on your lap for long periods.

  • And use condoms during sex for the first few weeks.

These precautions are temporary. You do not need to stay isolated from family or friends.

  1. High-Dose Rate (HDR) Brachytherapy:

HDR brachytherapy uses stronger radiation for a shorter time. Instead of permanent seeds:

  • Thin tubes called catheters (small flexible tubes) are placed into the prostate.

  • A radioactive source passes through the tubes.

  • And the source is removed after treatment.

Nothing radioactive stays inside the body afterward. Each treatment session usually lasts about 15 to 30 minutes. Some men may need multiple HDR treatment sessions, depending on the cancer stage and treatment plan. In certain protocols, HDR brachytherapy may be delivered in up to 4 treatment sessions within about 12 weeks, especially when combined with external radiation therapy for higher-risk prostate cancer.

HDR brachytherapy is often combined with external radiation therapy to improve cancer control. Since the radiation source is removed after treatment, there are no radiation safety concerns once you return home.

How Should You Prepare for Brachytherapy?

Before brachytherapy, your doctor will check your medical history, medicines, and overall health to help lower the risk of complications.

Before the procedure, you may be asked to:

  • Avoid eating or drinking for a few hours, especially if anesthesia will be used.

  • Tell your doctor about all medicines, vitamins, and herbal supplements you take.

  • Stop blood-thinning medicines, such as aspirin and certain pain relievers, about a week before treatment to reduce bleeding risk.

Do not stop any medicine without speaking to your doctor first

These medicines may include:

  • Aspirin.

  • Ibuprofen.

  • Naproxen.

  • Clopidogrel.

  • Other blood thinners.

Only stop these medicines after talking to your doctor.

Your doctor may also ask you to:

  • Stop smoking before treatment, as smoking can slow healing.

  • Avoid alcohol for a few days before and after the procedure.

  • Complete blood tests, urine tests, or scans before treatment planning.

Some patients may also need antibiotics or bowel preparation before the procedure. Following these instructions carefully can help lower the risk of complications and support a smoother recovery.

How Is Brachytherapy Performed?

Brachytherapy is usually done in a hospital or cancer treatment center. Before the procedure, doctors use scans such as ultrasound, CT (computed tomography), or MRI (magnetic resonance imaging) to carefully plan the treatment and locate the cancer inside the prostate.

During the procedure:

  • You receive spinal anesthesia (medicine that numbs the lower body) or general anesthesia (medicine that puts you to sleep),

  • An ultrasonic probe is inserted in the rectum to assist physicians in viewing the prostate gland.

  • Thin needles are used to place the radioactive seeds or treatment tubes into the prostate.

In LDR brachytherapy, the radioactive seeds remain permanently inside the prostate. For HDR brachytherapy, the radiation source is removed after treatment. The process lasts around 60-90 minutes, and patients usually return home that day or the next morning.

What Is Recovery Like After Brachytherapy?

Recovery after prostate brachytherapy is usually faster than recovery after major prostate surgery. Most men return home the same day or the next morning. However, recovery happens gradually over several weeks and months.

First Few Hours After the Procedure:

  • Most patients can walk normally within 2 to 3 hours after the anesthesia wears off.

  • Mild soreness, fatigue, or urinary discomfort is common.

  • Some men may temporarily need a urinary catheter if urination becomes difficult.

Doctors usually monitor patients for a short time before discharge.

First Few Days:

  • Many men return to light, non-strenuous activities within 2 to 3 days.

  • Heavy lifting, intense exercise, and strenuous physical activity should usually be avoided for at least several days.

  • Drinking plenty of fluids may help reduce urinary irritation.

Some urinary symptoms, such as frequent urination or a weak urine stream, may temporarily worsen before improving.

First Few Weeks:

  • Most patients gradually resume normal daily routines over the following weeks.

  • Sexual intercourse is often considered safe after about 2 weeks, although doctors may recommend using condoms temporarily after LDR brachytherapy.

  • Mild tiredness or bowel irritation may continue for a short period.

Recovery rates depend on various factors, including age, general health, and the use of external radiation treatment.

Postoperative Recovery Time

Urination, defecation, and sexual ability usually come back slowly with time. Recovery normally goes up to 6 to 12 months after surgery.

Follow-up visits usually include:

  • PSA blood tests.

  • Symptom monitoring.

  • Evaluation of urinary or sexual side effects.

Some men experience a temporary PSA bounce after treatment, which does not always mean the cancer has returned.

How Are the Implants Placed?

Doctors use ultrasound imaging to place the implants accurately. During the procedure:

  • An ultrasound probe is placed into the rectum to help doctors see the prostate in real time.

  • Thin needles are inserted through the skin between the scrotum and anus.

  • The radioactive seeds or treatment tubes are placed into the prostate with precision.

No large cuts or stitches are needed. For LDR brachytherapy, the tiny radioactive seeds remain inside the prostate permanently.

For HDR brachytherapy, temporary tubes are placed and removed after the radiation treatment is completed. Some patients may need a temporary urinary catheter (a thin tube used to drain urine) for a short time after the procedure if urination becomes difficult.

How Effective Is Brachytherapy?

Brachytherapy is one of the most successful treatment approaches for prostate cancer confined within the prostate gland. Many men are able to live long, healthy lives after treatment. The treatment works by delivering radiation directly to the cancer while limiting damage to nearby healthy tissue.

Recovery is tracked through PSA levels measured via blood tests, which typically slowly go down over time. The rise in PSA levels doesn't necessarily indicate a recurrence of the disease in some cases. Follow-ups are essential for monitoring the status of cancer management in the long run.

What Are the Advantages of Brachytherapy?

Brachytherapy offers several benefits for men with prostate cancer.

Some of the main advantages are:

  • Radiation is placed directly inside the prostate.

  • Nearby healthy tissue receives less radiation.

  • No major surgery is needed.

  • Recovery is usually faster.

  • The hospital stay is short.

  • And many men return to normal activities within a few days.

For many patients, brachytherapy also provides strong long-term cancer control with a lower risk of urinary leakage than surgery.

What Side Effects Can Occur After Brachytherapy?

Like all cancer treatments, brachytherapy can cause side effects. Some appear soon after treatment, while others may develop gradually over months or years.

Immediate Side Effects (Up to Several Days and Weeks)

These are mostly temporary side effects that will likely resolve once your prostate regenerates. They include the following common problems:

  • Difficulty urinating (burning sensation).

  • Frequent urination.

  • Difficulty starting urine flow.

  • Mild blood in the urine or semen.

  • Soreness or bruising in the area between the scrotum and anus.

  • Tiredness or fatigue.

Some men may temporarily need a urinary catheter if swelling makes urination difficult.

Short-Term Side Effects (Weeks to Months)

As the radiation continues to affect prostate tissue, some men may experience:

  • Weak urine stream.

  • Sudden urges to urinate.

  • Waking up frequently at night to urinate.

  • Mild bowel irritation.

  • Loose stools or rectal discomfort.

These symptoms usually improve gradually over several months.

Long-Term Side Effects (Months to Years)

Some side effects can persist or develop later after treatment. Possible long-term effects include:

  • Erectile dysfunction (ED).

  • Persistent urinary symptoms.

  • Rare bowel complications such as radiation proctitis.

  • Narrowing of the urethra (urethral stricture) in some patients.

Studies suggest that around 25 % of men may develop erectile dysfunction over time, while serious bowel complications such as radiation proctitis occur in fewer than 3 % of patients with modern treatment techniques.

Most men do not experience severe long-term complications, especially when treatment is carefully planned.

Conclusion:

Brachytherapy is a well-established treatment for prostate cancer that offers strong long-term cancer control for many men. Because it is less invasive than major surgery, recovery is often faster, and daily life may be less affected.

The right treatment depends on the stage of the cancer, overall health, and personal preferences. Talking with a cancer specialist can help you decide whether brachytherapy is the right option for you.

Key Takeaways:

  • Brachytherapy places radiation directly inside the prostate.

  • It is mainly used for prostate cancer that has not spread outside the gland.

  • There are two main types: LDR and HDR brachytherapy.

  • Most procedures take about 60 to 90 minutes.

  • Many men go home the same day.

  • Recovery is often quicker than major surgery.

  • PSA bounce after treatment is common and may not mean the cancer has returned.

  • Rates of cancer control are very high in appropriate candidates.

Listen to related tracks in our music library

Frequently Asked Questions

Brachytherapy is a form of internal radiation therapy in which radiation-containing seeds, ribbons, or capsules are inserted into or close to the tumor in the body. A single body component can only be treated locally using brachytherapy. Cancers of the head and neck (cervical), breast, cervix, prostate, and eye are often treated with it.
The majority of brachytherapy is implanted via a catheter, a thin, flexible tube. Brachytherapy may occasionally be applied using a bigger apparatus known as an applicator. The kind of malignancy determines the brachytherapy is administered. Before one starts treatment, the doctor will insert the catheter or applicator into the body.
Placing brachytherapy methods:
- Interstitial Brachytherapy: Involves putting the radiation source within the tumor. One use of this method is in the treatment of prostate cancer.
- Intracavity Brachytherapy: When the radiation source is positioned inside a bodily cavity or a surgically made cavity. For instance, endometrial or cervical cancer can be treated by injecting radiation into the vagina. The radiation source in episcleral brachytherapy is linked to the eye. Eye melanoma is treated using this method.
The radiation source is inserted within the catheter or applicator once it has been secured. The radiation source may be operational for a short while, for several days, or for the remainder of its life. 
- Low-Dose Rate (LDR) Implants: The radiation source is implanted for one to seven days during this kind of brachytherapy. The doctor will remove the radiation source and the catheter or applicator once the treatment is complete.
- High-Dose Rate (LDR) Implants: In this form of brachytherapy, the radiation source is inserted and removed every 10 to 20 minutes. An individual can receive therapy once a week for two to five weeks or twice daily for two to five days. The catheter or applicator may remain in place or be inserted during therapy. The cancer kind determines the timetable. When the treatment is complete, the doctor will remove the catheter or applicator, just like with LDR implants. 
- Permanent Implants: The catheter is removed once the radiation source has been installed. Although the implants are permanent in the body, the radiation grows weaker every day. Nearly the majority of the radiation will disappear over time. One should restrict the time one spends with others and take additional safety precautions when the radiation is installed. Avoid spending time with youngsters or pregnant women at all costs.
The type of cancer one has, and the type of brachytherapy one undergo will determine any potential adverse effects. Several months after the end of therapy, side symptoms usually get better.
- Urinary incontinence or difficulty urinating.
- Erection problems.
- Fatigue.
- Bowel incontinence, diarrhea, or constipation.
- Hair fall
- Headaches.
- Mouth ulcers
- Vomiting and nauseous.
Radiation can damage neighboring healthy and cancer cells, killing or slowing their development. Side effects may result from harm to healthy cells. Brachytherapy requires using an ultrasonic probe in the back route to ensure the seeds are placed in the proper area. Hence it is not appropriate if one has undergone surgery to remove the rectum (back passage). Thus it is always better to consult the doctor, where expertise can extract the information and data from the patient and create a treatment plan that provides the best outcomes.
According to research, surgery, and radiation therapy are equally successful in treating the condition, but in recent years, radiation therapy has gained popularity because it has fewer side effects. In the case of prostate cancer, because the prostate remains in the body, radiation methods like brachytherapy, though they can temporarily cure patients, are often far less effective than surgery at preventing prostate cancer recurrence.
With a median follow-up of 5.3 years, the brachytherapy boost patients had significantly better rates of biochemical disease-free survival and distant metastases-free survival with 92 % vs. 81 % and 97 % vs. 93 % for IMRT and brachytherapy boost, respectively.
Brachytherapy still must be a common practice in India, except for a few prestigious private institutes. Having said that, India continues to provide affordable brachytherapy treatment compared to other nations like the US and the UK. Depending on the suggested radiation technology, the typical cost of radiation therapy in India ranges from Rs. 30,000 to Rs. 20,00,000. However, the costs may range based on the hospitals in other cities like Hyderabad, 318,000 INR, 4,543 USD; Chennai, 324,000 INR, 4,629 USD; New Delhi, 336,000 INR, 4,800 USD.
The term "brachytherapy" also refers to internal radiation. A radioactive implant is placed in the vicinity of the tumor or inside the body. The implant placement process is often painless. One can receive a temporary or permanent implant depending on the cancer type and treatment regimen. One may feel physically drained and weak after receiving brachytherapy. This is referred as tiredness. It differs from regular fatigue because one could feel worn out after doing nothing. The body is just reacting to the therapy by attempting to restore any healthy cells that the brachytherapy may have harmed.
Following plaque brachytherapy, the following percentages were reached: 73 % at five years, 55 % at ten years, 43 % at fifteen years, 31 % at 20, 2 3% at 25, 19 % at 30, 16 % at 35, and 14 % at 40 years.
A person with a prostate tumor and a very low risk of metastasizing to other body regions is the ideal candidate for brachytherapy treatment. Patients with prostate cancer who are at moderate or high-risk benefit greatly from brachytherapy treatment.
Patients may receive therapy once a week for two to five weeks or twice daily for two to five days. Once the operation is finished, all radioactive sources utilized in temporary brachytherapy are completely removed. Although radioactive materials are specially chosen so that the radiation's energy is so low that there is a negligible risk to others, it is typically advised that the patient avoid close contact with children and pregnant women for up to two months. For permanent implants, the sources remain active in the body for many weeks, even years, in some cases. Iodine-125 seedlings lose 50 % of their vitality after every 60 days of decay. Their radioactivity has practically peaked after ten months.
Brachytherapy makes it feasible for the medical team to provide larger radiation doses than would be achievable with external radiation. This is so that radiation may be delivered precisely to the therapeutic region via brachytherapy. By doing this, the likelihood of damaging neighboring healthy tissue is reduced. But for various medical or non-medical reasons, some people cannot endure brachytherapy. Stereotactic body radiation (SBRT) is a therapeutic option for these individuals.
Due in part to the minimally invasive nature of the operation, patients might resume walking within a few hours and other typical activities within a few days. Most men can resume their regular activities one or two days following treatment since recovery is swift. With permanent seed brachytherapy, radiation is delivered directly into the prostate, causing less harm to nearby healthy tissue and reducing the chance of certain adverse effects. Some brachytherapy adverse effects start during or right after treatment and often start to subside after approximately two weeks. Brachytherapy after receiving chemotherapy and radiotherapy (chemoradiation). In that case, one may already feel exhausted and generally sick, so knowing what else to anticipate may be helpful.
The ideal patient for brachytherapy is someone who has a prostate tumour that is contained to the prostate gland and has a very low chance of metastasizing to other organs. Patients with intermediate- or high-risk prostate cancer benefit greatly from brachytherapy treatment. Breast cancer, lung cancer, rectal cancer, eye cancer, and skin cancer are additional gynecologic cancers that can be treated with it, along with cervical and uterine (endometrial) cancer.
Source Article IclonSourcesSource Article Arrow
Dr. Rajesh Gulati from iCliniq
Dr. Rajesh Gulati

Family Physician

Consult this doctor

Rate this article

Tags:

brachytherapyradiation therapy

Related topics

Does radiation therapy increase the risk of melanoma?

Why is radiation therapy suggested for my aunt, who underwent stage-2 papillary thyroid cancer surgery?

Could radiation therapy cause T-wave inversion?

Radiation Nephropathy - Causes, Symptoms, Diagnosis, and Treatment

Gynecological Cancers - a Multidisciplinary Approach

My mom had hysterectomy for adenocarcinoma. Is radiation therapy compulsory?

Ask your health query to a doctor online

Medical oncology

*guaranteed answer within 4 hours

Trustpilot

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.